院前院内急救一体化模式对重症创伤患者炎症反应和临床救治效果及预后的影响研究  

Effect of first-aid integration model in the front yard of hospital on inflammatory response,clinical treatment and prognosis in patients with severe trauma

作　　者：兰学文 梁宏 向明权 黄文伶 杨家朝 唐瑞康 郭哲 覃桦[2] LAN Xue-wen;LIANG Hong;XIANG Min-quan;HUANG Wen-ling;YANG Jia-chao;TANG Rui-kang;GUO Zhe;QIN Hua(The Emergency Department,Nanning Second People’s Hospital/the Third Affiliated Hospital of Guangxi Medical University,Nanning City,Guangxi Zhuang Autonomous Region,530031,China;Corresponding author at:Hospital Quality Management Office,the First Affiliated Hospital of Guangxi Medical University,Nanning City,Guangxi Zhuang Autonomous Region,530022,China)

机构地区：[1]南宁市第二人民医院/广西医科大学第三附属医院急诊科,广西南宁530031 [2]广西医科大学第一附属医院质量管理办公室,广西南宁530021

出　　处：《蛇志》2021年第3期286-289,303,共5页Journal of Snake

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(编号:Z2015203);广西壮族自治区卫生和计划生育委员会自筹经费科研课题(编号:Z20180964)。

摘　　要：目的探讨院前院内急救一体化模式对重症创伤患者炎症反应、临床救治效果及预后的影响。方法选取我院2015年6月-2017年6月急诊科收治的98例严重创伤患者作为本次研究对象,按随机数字表法分为观察组和对照组,每组49例。其中对照组患者采用常规急救模式,观察组患者采用院前院内急救一体化模式进行急救。比较两组患者的治疗消耗时间、救治效果、治疗前后血清炎性因子水平变化以及患者治疗6个月后的生活质量。结果观察组患者入院至手术室间隔时间、术前特殊检查时间、手术准备时间、住院时间均明显短于对照组,差异均有统计学意义(均P<0.05)。观察组患者死亡率为8.2%(4/49),明显低于对照组的24.5%(12/49),差异具有统计学意义(χ^(2)=4.783,P=0.029)。观察组的残疾率为8.9%(4/45),明显低于对照组的27.0%(10/37),差异具有统计学意义(χ^(2)=4.723,P=0.030)。观察组的并发症发生率低于对照组,差异具有统计学意义(P<0.05)。两组患者的[接到患者时(T_(0))、收治48 h(T_(1))、收治72 h(T_(2))]血清TNF-α、IL-6、IL-8水平均在T_(1)时升高,T_(2)时下降,两组不同时间点各指标比较,差异均有统计学意义(均P<0.05)。两组患者治疗后6个月的生活质量评分比较,观察组在生理功能、生理职能、情感职能方面的评分均明显低于对照组,差异均有统计学意义(均P<0.05)。结论院前院内急救一体化模式能明显缩短患者救治时间,减轻炎症反应,提高救治效果,有助于改善预后,提高患者生活质量。Objective To explore the effect of first-aid integration mode in the front yard on the inflammatory response,clinical treatment and prognosis of severe trauma patients.Methods Ninety-eight patients with severe trauma who were admitted to our hospital from June 2015 to June 2017 were enrolled.The patients were divided into observation group and control group according to the random number table,with 49 cases in each group.Among them,the control group patients used the routine first aid mode,and the observation group patients used the first-in-hospital first-aid integrated mode for first aid.The time of treatment,the effect of treatment,the changes of serum inflammatory factors before and after treatment,and the quality of life after 6 months of treatment were compared between the two groups.Results The interval between the admission group and the operating room,the preoperative special examination time,the operation preparation time,and the hospitalization time were significantly lower than the control group,and the difference was statistically significant(P<0.05).The mortality rate of the observation group was 8.2%(4/49),which was significantly lower than that of the control group[24.5%(12/49)],and the difference was statistically significant(χ^(2)=4.783,P=0.029).The disability rate of the observation group was 8.9%(4/45),which was significantly lower than that of the control group[27.0%(10/37)],and the difference was statistically significant(χ^(2)=4.723,P=0.030).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Serum TNF-α,IL-6,IL-8 increased at T_(1) at the time of receiving the patients(T_(0)),48h(T_(1)),and 72 h(T_(2)),and the T_(2) decreased.There were significant differences between the groups,at different time points,and between different time points(P<0.05).The life quality scores of the observation group were compared 6 months after treatment.The three indexes of physiological function,physiologica

关 键 词：急救一体化 重症创伤 炎症反应 

分 类 号：R641[医药卫生—外科学]